保留盆腔自主神经的宫颈癌根治术联合小金片对宫颈癌患者术后性功能、膀胱及直肠功能的影响

Effect of radical resection of cervical carcinoma with pelvic autonomic nerve preservation and Xiaojin Tablet on postoperative sexual function,bladder and rectum function in patients with cervical cancer

目的探讨保留盆腔自主神经的宫颈癌根治术联合小金片应用于早期宫颈癌中疗效,并观察其对患者术后性功能、膀胱及直肠功能的影响。方法将2012年6月~2016年6月收治的120例经手术组织病理学诊断为早期宫颈癌的患者按照随机数字表法分为对照组与治疗组,各60例,均开展保留盆腔自主神经的宫颈癌根治术治疗,治疗组加用小金片。记录2组患者平均手术时间与术中出血量;统计2组患者手术过程中切除韧带长度和阴道壁长度及清扫盆腔淋巴结数目;评价2组患者术后膀胱功能和直肠功能及性功能恢复情况。结果与对照组比较,治疗组平均手术时间、术中平均出血量未见明显统计学差异(P>0.05)。2组患者韧带切除长度(主韧带、骶韧带)、阴道壁切除长度(阴道前壁、阴道后壁)、清扫盆腔淋巴结数目差异均无统计学意义(P>0.05)。治疗组患者术后保留尿管时间、术后第10天残余尿量、术后肛门排气时间明显短于对照组(P<0.05);治疗组术后肛门排便时间为(88.7±12.2)h明显短于对照组(118.8±22.9)h(t=6.35,P=0.00)。治疗组患者术后6个月FSFI总分为(28.3±3.2)分明显高于对照组(20.1±2.5)分(t=11.06,P=0.00),而对照组患者治疗后FSFI总分相比术前下降(P<0.05),治疗组治疗前后相比未见明显差异(P>0.05)。结论临床应用保留盆腔自主神经的宫颈癌根治术联合小金片治疗早期宫颈癌患者疗效与单纯手术治疗效果相当,但联合小金片治疗可有利于患者术后膀胱功能及直肠功能恢复,且对患者术后性功能影响小。

Objective To investigate the curative effect of radical resection of cervical carcinoma with pelvic autonomic nerve preservation and Xiaojin Tablet on early cervical cancer, and to observe its effect on postoperative sexual function, bladder and rectum function. Methods 120 cases of patients with early cervical cancer diagnosed in our hospital from June, 2012 to June, 2016 were divided into control group and treatment group according to the method of random number table, and control group were treated with radical resection of cervical carcinoma with pelvic autonomic nerve pleservation, while the treatment group were with radical resection of cervical carcinoma with pelvic autonomic nerve preservation combined with Xiaojin Tablet. The average operation time and intraoperative blood loss were recorded. The length of ligament and the length of pelvic wall and the number of pelvic lymph nodes were counted. The bladder function, rectum function and sexual function recovery were evaluated in 2 groups. Results The length of ligament excision （main ligament, sacral ligament）, vaginal wall excision length （vaginal anterior wall, vaginal posterior wall）, the mean pelvic volume, The number of lymph nodes in the two were no significantly differences （P 〉 0.05 ） ; The postoperative anal defecation time was （88.7 ±12.2） h, which was shorter than that of the control group （118.8±22.9） h, t = 6.35, P = 0.00. The total score of FSFI at 6 months after operation in the treatment group was （28.3 ± 3.2 ） points, which was higher that, that in the control group （ 20.1 ± 2.5 ）, t = 11.06, P = 0.00, but the FSFI score of the control group wasn＇t as before. Conclusion Clinical application of radical resection of cervical carcinoma with pelvic autonomic nerve preservation and Xiaojin Tablet in the treatment of early cervical cancer patients could get a good efficacy and be beneficial in patients with postoperative bladder function and rectal function recovery, and small postoperative sexual function Impact, which is better than the efficacy of surgery alone.